My Child has a loose Permanent Front Tooth.

I received an e-mail at drmax@drmaxwood.com from a C. Biswas in another country asking for advice on a dental problem their child was having.  The problem was that the milk tooth (baby tooth) had been lost and the permanent front tooth (central incisor) had replaced it, but the tooth had become loose.  The child’s parent wanted advice on what to do to prevent the loss of the permanent tooth.  They wanted to know also if the tooth would be replaced by another tooth growing in.  I told them that there would be no replacement tooth to replace the permanent tooth if it was lost.  I sent an e-mail to them, but thought it might be a topic that other people might have an interest in.  Permanent teeth do not have complete root formation when the tooth erupts, but the root continues to develop over time after eruption of the tooth.  This makes them less stable in the bone.

There are 3 main causes a permanent tooth to become loose in children.  They are: 1) an injury that affects that specific tooth; 2) some form of periodontal disorder that destroys the supportive bone around the tooth; and 3) a traumatic occlusion (bite) that causes one tooth to hit before all the other teeth when biting down.

Most traumatic injuries to teeth are from a blow to the face, or a fall that involves the mouth hitting something.  In most cases the best treatment is to splint, or to  attach it to the adjacent teeth by bonding a wire to the teeth with a tooth colored filling material.  If no adjacent teeth are available on both sides of the affected tooth, then some type of removable retainer should be used to stabilize the tooth.

I have only seen periodontal disease in 3 children in 25 years of practice.  One was a congenital defect in the gum tissue itself.  This case required corrective surgery to resolve the problem  The other two were in children with so much plaque and tartar build up on their teeth that the tooth itself could barely be seen.   This required removal of the plaque and tartar.  The periodontal problems were still minor and so oral hygiene instructions were given and we are monitoring there periodontal health during their 6 month check ups.

The 3rd cause is traumatic occlusion, or bite is the easiest to fix.  After evaluation of the child’s bite, the bite is adjusted by selective contouring the enamel to even out the bite so that all teeth are hitting at the same time.  Usually no splint or stabilization is necessary with this type of mobility or that caused by periodontal problems.

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DISCLAIMER: This blog is meant for informational purposes only. It is not meant to diagnose or treat any specific dental or medical problem. If you do have a problem, please consult your dentist or doctor for treatment.

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Comments

Hi,
I was totally freaked out this morning, when my 6 year old told me that one of her bottom permanent tooth was wiggling. After reading your comment, I am not a dentist, but I think , she has a bite issue, I felt so much better.
Thank you so much for the information.

Z

ok so i am sort of a child (i guess) i have a loose permanent tooth but none of your options seem right to me. it was never knocked on or like hit or kicked, i am almost positive i dont have gum disease (as said yourself its rare in children) and i dont have a bite. it is the bottom tooth, first one on the left from the center. one day i was just tapping at my teeth when i noticed it was loose. its only slightly loose but it still worries me. i dont want to have a fake tooth or something (i over exaggerate alot) but my mom doesnt think its loose, and im afraid to let her wiggle it because i saw on the internet not to ever wiggle it. i dont know what to do about my tooth, its not smothered in plaque, its barely plaquey. and i had no accident or anything. and i dont wanna have something done and its been maybe a month or less since i noticed it was loose just barely it hasnt gotten worse or better, will it maybe tighten up on its own after a long while??? please answer, thanks!!!!!!!

oh and every now and then i check juuust slightly to see if it is still loose, and it is. i dont like to eat on it so i like to bite on the side of my mouth kinda. and i have very crooked teeth so i often obsessivley, without trying i guess i will (with my mouth closed usually) move my jaw up so the loose tooth taps against my front left tooth and it kinda wiggles i THINK but i dont know for sure i dont think it is wiggling it might just be my imagination.

Great article an information thank you, so much after looking closely to the tooth I believe the one is longer than the other. we have a dental appt. thanks again

I have a 14 year old child, and she has braces, and she complains that a couple of her teeth seem loose. And they are all adult/permanent teeth. She’s scared of having those teeth fall out, because she’s only 14. Why are they loose? She doesn’t have any of the above 3 reasons stated in this article. Any guesses?

When orthodontics are done, the forces on the teeth cause them to move through the bone. The pressure causes the bone to actually change to allow the teeth to move; so the bone dissolves on one side and hardens on the other side. In other words, her teeth are a little bit loose, but will not fall out. Once the orthodontic treatment is done and retainers are placed, then the bone around the teeth will harden and that feeling of the teeth being loose will go away. Good luck with the orthodontic treatment.

Thank you and good luck.

Probably should have it checked out. Sometimes there are very simple ways to correct these type of problems without a lot of expense. Good luck to you.

I would have it checked out by a dentist and see what they have to say. I would watch it and make sure your dental hygiene is very good, especially flossing. Sometimes we need to have a dentist check things out to make sure that none of the problems I mentioned are going on, or anything else. Good luck.

When the permanent teeth erupt, the root of the tooth is still forming and this can make the teeth wiggle a little. As the root becomes fully developed and the bone hardens around it, the tooth will wiggle less and less until it doesn’t wiggle at all. If it continues to wiggle, have her checked out by a dentist. Good luck.

My son is having this same problem! He is 5 and he has his bottom two permanent teeth and the one next to his permanent tooth is loose, is it possible that the loose tooth is making his permanent teeth loose?

My front tooth on the right is a little loose. I don’t know what to do please help I wan’t to know if I need to get it checked out or not?

The permanent teeth are not completely formed. The roots of the teeth are still forming in the bone and that is why they are loose. Tell your son not to wiggle them. Have him eat soft foods if he has to bite into it with his front teeth. It would probably be best to have him eat most of his food with a knife or spoon to help protect those teeth. The loose baby teeth may be part of the problem because the bone under them is being dissolved to allow the permanent teeth to come in. He should be OK as long as he is careful.

The biggest issue with this is determined by how old you are. If you are older than 10 years old, then yes, you should have it checked. If you are under 10 years old, it depends on whether it is a permanent tooth, or a baby tooth. If it is a baby tooth, then it will continue to loosen until it falls out. If it is a permanent tooth, it should firm up with time. If you are not sure what to do, the safest thing to do is get it checked out. Good luck, Dr. Max

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